Nasal irrigation is a personal hygiene practice in which the nasal cavity is washed to flush out excess mucus and debris from the nose and sinuses. The practice of nasal irrigation dates back to an Ayurvedic medicine technique in ancient India. Nasal irrigation promotes good sinus and nasal health, and can provide effective relief to symptoms of facial pain, headache, halitosis, cough, anterior rhinorrhea (watery discharge) and nasal congestion. Daily saline nasal irrigation can bring relief from allergens and increase immunity to common colds and flu. Flushing the nasal cavity with salt water moisturizes the nasal cavity and removes encrusted material. In proper proportion, nasal salt water solution with slight acidic pH functions as an anti-bacterial irrigant. The flow of salt water through the nasal passage flushes the dirt, airborne allergens (dust and pollen), pollutants and bacteria-filled mucus. Salt water flushing also loosens and thins the mucus, making it easier to expel, and allowing the cilia (hairs in the nasal passage) to function more efficiently in pushing excess mucus either to the back of the throat or to the nose to be expelled.
The source of water that is used with nasal rinsing devices is important, as tap water often contains low levels of organisms, such as microscopic amoebas. Of particular concern is the amoeba Naegleria fowleri, which is commonly found in the environment, including in warm freshwater lakes and rivers that supply municipal drinking water treatment plants. Primary amebic meningoencephalitis (PAM), which is usually fatal, occurs when Naegleria fowleri-containing water enters the nose and migrates to the brain via the olfactory nerve. The infective stage of Naegleria fowleri is the ameboid trophozoite cycle of its life, at which point the amoeba is 10-35 μm long.
Some manufacturers of devices currently on the market for nasal irrigation recommend using distilled water for nasal irrigation, but many users use hot tap water because it is more comfortable and convenient. In 2011, two adults died in Louisiana hospitals of PAM as a result of using tap water for regular sinus irrigation with neti pots. These were the first reported PAM cases in the United States that were associated with the presence of Naegleria fowleri in household plumbing served by treated municipal water. On Sep. 12, 2013 the Louisiana Department of Health and Hospitals reported that parish water in Violet and Arabi tested positive for the Naegleria fowleri amoeba that killed a 4-year-old Mississippi boy in August after he visited St. Bernard Parish. According to the Center for Disease Control and Prevention, the St. Bernard Parish case was the first in which the Naegleria amoeba was found in water treated by a U.S. water system. In countries where the practice of nasal irrigation is common there has been an increase in cases of PAM that have been attributed to nasal irrigation. From 2008-2009 there were 13 patients in Karachi, Pakistan whose death from Naegleria fowleri meningoencephalitis was attributed to using tap water to clean their sinuses.
Devices that are currently available for nasal irrigation in a residential setting do not provide a warm or sanitized solution to use for nasal irrigation. The present invention overcomes these deficiencies by providing an appliance that allows tap water to be safely used for nasal irrigation, and optimizing the nasal irrigation experience and benefits with customizable control of the sodium concentration and temperature of the saline solution.
The disclosures of the following references are incorporated herein by reference:                1. Yoder, J. S., Straif-Bourgeois, S., Roy, S. L., et al. 2012. Primary Amebic Meningoencephalitis Deaths Associated With Sinus Irrigation Using Contaminated Tap Water, Clinical Infectious Diseases: cis626v1-cis626.        2. Shakoor S, Beg M A, Mahmood S F, Bandea R, Sriram R, Noman F, et al. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerging Infectious. Diseases [serial on the Internet]. 2011 Feb. [date cited]. http://dx.doi.org/10.3201/eid1702.100442        3. Rabago D, Guerard E, Bukstein D. Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis. Wisconsin Medical Journal. 107(2):69-75, 2008.        4. Pynnonen M A, Mukerji S S, Kim H M, et al. Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Arch Otolaryngol Head Neck Surg. 2007; 133:1115-1120.        5. Rabago D, Barrett B, Marchand L, Maberry R, Mundt M. Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multi-method study. Annals of Family Medicine. 2006; 4:295-301.        6. Rabago D, Pasic T, Zgierska A, Barrett B, Mundt M, Maberry R. The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms. Otolaryngol Head Neck Surg. 2005; 133:3-8.        7. Rabago D, Zgierska A, Mundt M, et al. Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. Journal of Family Practice. 2002; 51(12):1049-1055.        8. Heatley D G, McConnell K E, Kille T L, Leverson G E. Nasal irrigation for the alleviation of sinonasal symptoms, Otolaryngol Head Neck Surgery. 125(1):44-48, 2001.        